No Pain, No Gain?

Do you have hip pain, knee, pain, or even back pain? In the past it’s been said when it comes to exercise, no pain, no gain.  While many people still adhere to that concept what we’ve recently learned is that people who don’t exercise regularly are at greater risk of chronic pain and exercising regularly can reduce the risk of chronic pain. A recent study published in the March edition of Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine (ACSM), looked at the relationship between physical activity and pain in adults in the United States. The study’s findings regarding chronic pain are worth taking a closer look at.  

At our sports medicine clinic in Portland, Oregon, we see pain present in many different forms with our patients.  We might see someone with acute pain from a recent trip and fall onto their knee, another person who has recurring shoulder pain from excessive lifting at work, a runner with hip pain, or someone experiencing chronic neck and back pain from prolonged sitting. Each of these types of pain, likely interfere with and adversely affect the individuals’ ability to be physically active. 

In general, chronic pain is one of the most common reasons adults seek medical care at our practice. According to the article and based on data from 2019, approximately 20% of adults in the United States are dealing with chronic pain on most days. Chronic pain commonly results in limitations with work related activities, social activities, and other daily activities.

In our sports medicine clinic, we commonly ask our patients about their exercise experience to help develop an exercise program as a treatment for their chronic pain. We commonly recommend treatment such as physical therapy or home exercise programs.

According to the Center for Disease Control (CDC), only 23% of adults over age 18 in the United States meet the recommended physical activity guidelines.   Previous studies have shown that physical activity can lessen the risk of developing chronic pain and help individuals reduce their perceived pain.  This recent study in the ACSM journal looked at over 30,000 US adults.   It found that most of the study sample (approximately 63%) reported experiencing an episode of pain over the past three months. Approximately 40% reported pain on some days, and almost 15% reported pain every day.  Approximately 27% of the participants reported their pain intensity as mild while 11% reported it as severe. Just over 70% of the study participants reported receiving prescription medicine in the prior 12 months. Of those having pain, just under 50% of the participants reported utilizing over-the-counter medicines to manage their pain. The study found that the odds of engaging in physical activity, decreased in a stepwise fashion based on the frequency and intensity of pain reported when compared to those with who were pain free. The study concluded there is a significant correlation between meeting physical activity, guidelines, and pain. Meeting both strength and aerobic criteria of physical activity guidelines resulted in lower odds of reporting pain. In addition, the odds of participating in physical activity decreased based on the frequency of pain. This study highlights the need for assessing physical activity for those dealing with pain, and physical activity as a preventative measure for reducing the development of chronic pain.

Author

David Westerdahl MD FAAFP RMSK Sports Medicine Physician and owner Sports Health Northwest, Inc.